title: Predictive parameters of intraoperative blood loss in patients who underwent pancreatectomy.
abstract: OBJECTIVE
  Despite recent advances in surgical techniques, blood loss is an important factor associated with postoperative outcomes in pancreatectomy. It is useful to identify risk factors of increased blood loss.
  
  
  METHODS
  The clinical records of 161 patients who underwent an elective pancreatectomy for peripancreatic diseases between 1994 and March 2011 were retrospectively examined. Univariate and multivariate analysis of clinicopathological and surgical parameters influencing intraoperative blood loss were performed. We determined the cut-off value of the amount of blood loss based on the analyzed results.
  
  
  RESULTS
  The mean and median blood loss was 1346±901 and 1070 mL, respectively. Red cell blood transfusion was performed in 72 patients (45%). Based on ROC analysis, the predictive value of blood loss in patients who received red cell blood transfusion was 880 mL (p <0.001); however, blood loss was not significantly associated with postoperative complications (p = 0.40). The cut-off level of estimated amount of blood loss in the present study was set at 880 mL. Male patients, fatty pancreas, higher serum alkaline phosphatase level, longer operating time, performance of pancreaticoduodenectomy (PD) and combined resections of adjacent major vessels were associated with significantly more increased blood loss (p <0.05). Based on multivariate analysis, longer operation time over 480 minutes and performance of PD were significantly associated with increased blood loss (p <0.05).
  
  
  CONCLUSIONS
  Attempting to reduce operating time in cases of PD is necessary to reduce intraoperative blood loss.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Nanashima
authors.forename: Takafumi
authors.initials: T
authors.lastname: Abo
authors.forename: Keiko
authors.initials: K
authors.lastname: Hamasaki
authors.forename: Kouki
authors.initials: K
authors.lastname: Wakata
authors.forename: Masaki
authors.initials: M
authors.lastname: Kunizaki
authors.forename: Kenjiro
authors.initials: K
authors.lastname: Nakao
authors.forename: Kenji
authors.initials: K
authors.lastname: Tanaka
authors.forename: Daisuke
authors.initials: D
authors.lastname: Fukuda
authors.forename: Toshiya
authors.initials: T
authors.lastname: Nagasaki
authors.forename: Kazuo
authors.initials: K
authors.lastname: Tou
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Takeshita
authors.forename: Shigekazu
authors.initials: S
authors.lastname: Hidaka
authors.forename: Terumitsu
authors.initials: T
authors.lastname: Sawai
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016063:Blood Loss, Surgical; D017707:Erythrocyte Transfusion; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010180:Pancreatectomy / Q000009:adverse effects*; D016577:Pancreaticoduodenectomy / Q000009:adverse effects; D012189:Retrospective Studies